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2017 年至 2020 年坦桑尼亚麻风病负担及相关残疾风险因素。

Burden of leprosy and associated risk factors for disabilities in Tanzania from 2017 to 2020.

机构信息

Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.

Tanzania Field Epidemiology and Laboratory Training Program, Ministry of Health, Dar es Salaam, Tanzania.

出版信息

PLoS One. 2024 Oct 10;19(10):e0311676. doi: 10.1371/journal.pone.0311676. eCollection 2024.

Abstract

BACKGROUND

Leprosy is caused by Mycobacterium leprae which affects skin, nerves, eyes, and nasal mucosa. Despite global elimination efforts, Tanzania remains among 13 countries reporting more than 1000 leprosy cases annually. In 2021, Tanzania identified 1,511 new cases, with 10% having grade II disability. Moreover, 14 councils recorded leprosy rates exceeding 10 cases per 100,000 population. This study aimed to assess the burden of leprosy and associated risk factors for disabilities in Tanzania from 2017 to 2020.

METHODOLOGY

A retrospective cross-sectional study was conducted to investigate all registered treated leprosy patients from January 2017 to December 2020. The Leprosy Burden Score (LBS) was used to assess the disease burden, while binary logistic regression was employed to evaluate the risk factors for disability.

RESULT

A total of 6,963 leprosy cases were identified from 2017 to 2020. During this period, the point prevalence of leprosy declined from 0.32 to 0.25 per 10,000 people, and the new case detection rate decreased from 3.1 to 2.4 per 100,000 people; however, these changes were not statistically significant (p > 0.05). Independent risk factors for leprosy-related disabilities included male sex (Adjusted Odds Ratio (AOR) = 1.38, 95% Confidence Interval (CI) 1.22-1.57), age 15 years and above (AOR = 2.42, 95% CI 1.60-3.67), previous treatment history (AOR = 2.18, 95% CI 1.69-2.82), and positive Human Immunodeficiency Virus (HIV) status (AOR = 1.60, 95% CI 1.11-2.30).

CONCLUSION

This study identified male sex, older age, positive HIV status, and prior treatment history as independent risk factors for leprosy-related disabilities. Additionally, despite the observed decline in point prevalence and new case detection rates, these changes were not statistically significant. To address leprosy-related disabilities, it is crucial to implement specific prevention strategies that focus on high-risk groups. This can be accomplished by enhancing screening and contact tracing efforts for early patient identification to prevent delays in intervention. Further research is warranted to analyze the burden of leprosy over a more extended period and to explore additional risk factors not covered in this study.

摘要

背景

麻风病是由麻风分枝杆菌引起的,可影响皮肤、神经、眼睛和鼻黏膜。尽管全球正在努力消除麻风病,但坦桑尼亚仍有 13 个国家每年报告超过 1000 例麻风病病例。2021 年,坦桑尼亚发现了 1511 例新病例,其中 10%的病例存在二级残疾。此外,有 14 个议会记录的麻风病发病率超过每 10 万人 10 例。本研究旨在评估 2017 年至 2020 年期间坦桑尼亚麻风病的负担和与残疾相关的风险因素。

方法

本研究采用回顾性横断面研究方法,调查了 2017 年 1 月至 2020 年 12 月期间所有登记的治疗麻风病患者。采用麻风病负担评分(LBS)评估疾病负担,采用二项逻辑回归评估残疾的风险因素。

结果

2017 年至 2020 年共发现 6963 例麻风病病例。在此期间,麻风病的点患病率从 0.32 降至 0.25/10000 人,新病例检出率从 3.1 降至 2.4/100000 人;但这些变化无统计学意义(p>0.05)。与麻风病相关残疾的独立风险因素包括男性(调整比值比(AOR)=1.38,95%置信区间(CI)1.22-1.57)、年龄 15 岁及以上(AOR=2.42,95%CI 1.60-3.67)、既往治疗史(AOR=2.18,95%CI 1.69-2.82)和 HIV 阳性(AOR=1.60,95%CI 1.11-2.30)。

结论

本研究发现,男性、年龄较大、HIV 阳性和既往治疗史是与麻风病相关残疾的独立风险因素。此外,尽管观察到点患病率和新病例检出率有所下降,但这些变化无统计学意义。为了应对与麻风病相关的残疾问题,必须实施针对高危人群的具体预防策略。这可以通过加强对早期患者的筛查和接触者追踪,以防止干预延误来实现。还需要进一步的研究来分析更长时间内麻风病的负担,并探讨本研究未涵盖的其他风险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/21fb/11466380/e28fdad8f51c/pone.0311676.g001.jpg

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